Intradural Extramedullary Meningioma at Upper Cervical Level: A Case Report

DOI:

Hasan ASM Q1 , Ahmed A2 , Islam Md. N3 , Roy M4 , Ralunans M5

Abstract

Intradural extramedullary tumors constitute two thirds of all spinal neoplasms. Schwannoma and meningiomas make up approximately 90% of the total and occur in equal numbers!. Epidemiological study suggests that spinal tumors occur with an approximate annual incidence of 2 per 100000 populations. However with the increasing availability of newer radiological tools such as MRI (Magnetic resonance imaging) spinal cord tumors are being diagnosed more frequently2. Approximately 20% of all central nervous system tumors lie within the spinal canal. incidence of location suggests that 25% are extradural, 50% are intradural extramedullary, and 25% are intramedullary3. Clinical presentation includes radicular pain, definite sensory level, weakness of the limbs often associated with hyperreflexia and spasticity, bowel & bladder involvement. Clinical presentation is useful in determining the exact location and level of the spinal lesion4. MRI has become the primary diagnostic modality in the assessment of intradural extramedullary lesion54. Sometimes plain x-ray and CT myelogram may be helpful. A young female patient of 34 years was presented with the complaints of upper neck pain, hyperaesthesia and difficulty to walk. MRI of cervical rcgion reveals intradural cxtramcdullary mass extending from CI to upper border of C3 with moderate enhancement in gadolinium. It was a transition zone between a mobile cranium & relatively rigid spinal column and is also at the site of the craniospinal junction. Removal of posterior arch of Cl and laminectomy of C2 with total removal of the SOL (space occupying lesion) was performed without damaging important structures & without any support from posterior site. Peroperative impression and histopathological findings confirm psammomatous type meningioma. After operation there was improvement of signs and symptoms and patient could walk without any support during discharge from the hospital and the postoperative period was uneventful.

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  1. Professor and Head of Neurosurgery

    Holy Family Red Crescent Medical College, Dhaka

  2. Assistant Professor of Pathology & Histopathology

    Holy Family Red Crescent Medical College, Dhaka

  3. Professor and Head of Orthopaedics

    Holy Family Red Crescent Medical College, Dhaka

  4. Registrar, Department of Neurosurgery

    Holy Family Red Crescent Medical College, Dhaka

  5. Assistant Professor of Dermatology

    Holy Family Red Crescent Medical College, Dhaka


Volume 30, Number 1 January 2019
Page: 30-33